Scientists from Imperial College London found cancer is the leading cause of death among people with diabetes.
The researchers that between 2001-2018 heart disease and stroke were no longer the leading causes of death among people with diabetes, as they were 18 years ago.
The research is published in the journal The Lancet Diabetes & Endocrinology and was conducted by Dr. Jonathan Pearson-Stuttard et al.
Diabetes affects 4.7 million people in the UK, and is caused by the body being unable to regulate blood sugar levels.
Around 90 percent have type 2 diabetes, which is associated with lifestyle factors such as high blood pressure and excess weight.
The remainder has type 1 diabetes, which is caused by the body attacking the cells that produce insulin, the hormone that controls blood sugar.
In the study, researchers looked at primary care data from 313,907 people in England with diabetes between 2001-2018 and linked this with death data from the Office of National Statistics.
The study found death rates for those with diabetes declined in the study period by 32 percent for men, and 31 percent for women.
The team explain deaths from heart disease and stroke have reduced across the whole population, including those without diabetes.
They suggest improvements in risk factors such as smoking and blood pressure, along with progress in medical treatments have contributed to large falls in deaths from heart disease and stroke.
The improvements have been even greater in those with diabetes. This has resulted in vascular conditions accounting for around 25 percent of all deaths in those with diabetes compared to 45 percent 20 years ago.
In contrast, improvements in cancer death rates have been much more modest, with improvements in those with diabetes lagging behind the general population.
It is striking that cancer is now the leading cause of death in England among people with diabetes and the leading contributor to excess death compared to those without diabetes.
The findings also showed people with diabetes were more likely to die from dementia, liver disease, or respiratory disease in 2018 than people without diabetes.
Death rates were higher in those with diabetes compared to those without in almost all causes studied.
Death rates for liver disease and dementia were twice as high in those with diabetes compared to those without in 2018, while respiratory death rates were 80 percent higher.
The research team says individuals with diabetes have up to a two-fold increased risk of dementia compared with those without diabetes.
The precise link for this is unclear but there are several shared risk factors such as smoking, obesity and poor diet between diabetes and dementia.
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